心包剥脱术围术期中心静脉压变化与近远期临床结果的关系

The relationship between the perioperative changes of central venous pressure and short-term and longterm clinical outcomes in pericardiectomy

目的总结分析心包剥脱术治疗缩窄性心包炎(constrictive pericarditis,CP)不同阶段中心静脉压(central venous pressure,CVP)变化与近远期临床结果的关系.方法回顾性研究我院2000年1月至2014年12月期间收治的237例CP患者的临床资料,监测术前和术后CVP变化,随访患者术后近远期临床结果.结果心包剥脱术后患者CVP从术前(19.5±4.8)mm Hg明显下降至术后(8.9±2.8)mm Hg,围手术期死亡(术后30 d内死亡)15例(6.3%).远期随访死亡7例(0.3%).术前CVP>15 mm Hg,出现术后近远期死亡的风险越高.术后CVP下降越明显,患者术后近远期效果越好,出现死亡风险越低.结论心包剥脱术可明显降低患者CVP,CVP变化与患者术后近远期临床结果具有相关性.

Objective To summarize and analyze the relationship between the changes of central venous pressure(CVP)at different stages of pericardiectomy on 237 patients with constrictive pericarditis(CP)and the short-term and long-term clinical outcomes.Methods The clinical data of 237 patients with CP from January 2000 to December 2014 in our hospital were retrospectively studied.The changes of CVP before and after operation were monitored and the short-term and long-term clinical results were followed up.Results After pericardiectomy,CVP(19.5±4.8)mm Hg decreased significantly from the preoperative to the postoperative(8.9±2.8)mm Hg and 15 patients(6.3%)died during the perioperative period(within 30 days afier operation).7 patients(0.3%)died in long-term follow-up.Preoperative CVP>15 mm Hg increased the risk of short-term and long-term mortality.The more obvious the decrease of CVP after operation,the better the short-term and long-term efect and the lower the risk of death.Conclusion Pericardiectomy can significantly reduce the CVP in the patients and the changes of CVP are correlated with the short-term and long-term after the operation.